Collagen is the most abundant protein in the human body and plays an essential role in determining the mechanical properties of the tissues. Both as a monomeric protein and in fibrous assemblies, collagen interacts with its surrounding molecules, in particular with water. Interestingly, while it is well established that the interaction with water strongly influences the molecular and mechanical properties of collagen and its assemblies, the underlying mechanisms remain largely unknown. Here, we review the research conducted over the past 30 years on the interplay between water and collagen and its relevance for tissue properties. We discuss the water–collagen interaction on relevant time- and length scales, ranging from the vital role of water in stabilizing the characteristic triple helix structure to the negative impact of dehydration on the mechanical properties of tissues. A better understanding of the water–collagen interaction will help to unravel the effect of mutations and defective collagen production in collagen-related diseases and to pinpoint the key design features required to synthesize collagen-based biomimetic tissues with tailored mechanical properties.